Sleep Apnea: What does it have to do with Dentistry?

Almost 18 million Americans suffer from the disorder sleep apnea. Sleep apnea occurs when a person’s airways become obstructed during sleep. The word apnea means the temporary cessation of breathing. Many people are familiar with Continuous Positive Airway Pressure (CPAP) machines to treat sleep apnea, but one alternative treatment is an oral appliance. At South Charlotte Dentistry we use the latest technology to examine your oral structure and can handcraft an oral appliance that can help relieve your sleep apnea problem.

There are two oral appliances made to assist with sleep apnea and snoring: the Jaw Advancing Device (JAD) or the Mandibular Advancement Device (MAD). Dentists make these oral appliances after taking a mold of a patient’s mouth. These devices are great treatments for sleep apnea and are even effective in stopping snoring. Some benefits to using an oral appliance to treat sleep apnea include that it is compact and portable, it is discreet, and most patients see an immediate response.

The goal of these kinds of oral appliances is to move a patient’s jaw forward, which essentially increases airway size and reduces air resistance against your muscles. Air resistance often is the cause of sleep apnea and snoring. Oral devices work to cut down on airway turbulence which stops snoring, which means that even if you don’t have severe sleep apnea, an oral appliance may still help a patient get better, more restorative sleep at night.

What is sleep apnea?

Sleep apnea is a common sleep disorder. There are 2 types of sleep apnea: obstructive sleep apnea and central sleep apnea. Obstructive sleep apnea is the most common form of sleep apnea. Obstructive sleep apnea occurs when the soft tissue at the back of the throat collapses when you’re asleep. This soft tissue blocks the airflow during sleep and causes the apnea. Central sleep apnea results not from a blocked airway, but when there is a problem with how the brain signals the breathing muscles. Central sleep apnea is often seen in conjunction with conditions like brain tumors, heart failure, and stroke.

Who can suffer from sleep apnea?

Approximately 15 percent of adults suffer from some form of sleep apnea. Men are more likely to develop sleep apnea. Sleep apnea is also more common when:

You are over 40

You are overweight

You have a large tongue or tonsils

You have a family history of sleep apnea

You have issues with nasal obstructions because of a deviated septum*, sinus problems, or allergies.

*The bone and cartilage between your nostrils are your nasal septum. A deviated septum is when this bone or cartilage are not centered. You can be born with a deviated septum or your septum can become deviated due to trauma, such as a broken nose.

Snoring or sleep apnea?

How do you know if you just snore a little from time to time or suffer from sleep apnea? Ask someone who knows your sleep patterns, like a roommate, partner, parent, or child. Ask if you stop breathing for several seconds at a time during sleep. Another warning sign snoring volume. Loud snoring is not only an annoyance to your partner, but if it is loud enough to be heard through a closed door, it’s a good sign of sleep apnea.

Other sleep apnea symptoms

If you don’t have a partner or you live alone, you can look for other symptoms. Many people who suffer from sleep apnea also experience excessive daytime sleepiness. You may notice yourself nodding off while working at your desk or sitting in front of the television. Exhaustion is also a symptom of sleep apnea. Disturbed sleep is not restorative sleep. Restorative sleep is critical to brain function. According to the National Sleep Foundation, fatigue can be just as dangerous as drinking when it comes to driving. “Drowsy driving is dangerous because sleep deprivation can have similar effects on your body as drinking alcohol,” the foundation states. “Being awake for 18 hours straight makes you drive like you have a blood alcohol level of .05 (for reference, .08 is considered drunk). If you’ve been awake for a full 24 hours and drive—say, after a night where you just couldn’t fall asleep—it’s like you have a blood alcohol level of .10.” Some people may not realize that they may have had hours of sleep but that the sleep itself wasn’t quality sleep. This kind of sleep can leave you still feeling exhausted. There’s morning grogginess, and then there’s the feeling of waking up feeling worse than when you went to bed.

Epworth Sleepiness Scale

The Epworth Sleepiness Scale is used to assess a person’s daytime sleepiness. It includes an eight-question questionnaire where you are asked to rate your likelihood of drifting off during eight different activities. Respondents rate themselves on a scale of 0 to 3:

0 = would never doze off

1 = slight chance of dozing

2 = moderate chance of dozing

3 = high chance of dozing

The questionnaire asks each person to rate themselves during the following activities:

Sitting and reading

Watching TV

Sitting inactive in a public place

As a passenger in a car for an hour without a break

Lying down to rest in the afternoon when circumstances permit

Sitting talking to someone

Sitting quietly after a lunch without alcohol

In a car, while stopped for a few minutes in traffic

After filling out the questionnaire, the responses are totaled for a final rating.

0-5 – Lower/normal daytime sleepiness

6-10 – Higher/normal daytime sleepiness

11-12 – Mild/excessive daytime sleepiness

13-15 – Moderate/excessive daytime sleepiness

16-24 – Severe/excessive daytime sleepiness

What are the long term effects of sleep apnea?

Sleep apnea is a serious sleep disorder that should be treated as soon as possible. Sleep apnea can lead to several severe health problems.

High blood pressure – This occurs when the force of your blood pushing through your blood vessels is too high. When this happens consistently it can cause damage to your heart and circulatory system.

Stroke – A stroke is when the blood flow to a part of the brain is cut off. During this time the brain cannot receive oxygen and brain cells begin to die. The brain cells that die during a stroke can affect memory and muscle control.

Heart failure – Heart failure occurs when the heart cannot pump or fill properly. This often occurs because the muscles in the heart are weakened and cannot pump enough blood to the body.

Diabetes – Diabetes is a disease where the body cannot produce or respond to insulin correctly. The results in elevated sugar levels in the blood.

Depression – Depression can cause sadness and a loss of interest in activities. Depression is a serious illness that can affect your ability to function at work and at home.

ADHD symptoms – ADHD stands for attention-deficit/hyperactivity disorder. This is common in children but also affects many adults. The most common symptoms include inattention, hyperactivity, and impulsiveness.

What is the STOP/BANG test?

The STOP/BANG test offers yet another series of questions to help determine if an individual suffers from sleep apnea. We provide information about the STOP/BANG test at South Charlotte Dentistry so that patients may discuss the results with their doctors.

STOP:

Snoring? Do you snore loudly?

Tired? Are you often tired, fatigued, or sleepy during the day?

Observed? Has someone observed you stop breathing (or choking or gasping) during sleep?

Pressure? Do you have high blood pressure? Are you being treated?

BANG

BMI? Is your BMI more than 35 kg/m?

Age? Are you over 50?

Neck? What is your neck size?

Gender? Men are more likely to suffer from sleep apnea.

Sleep apnea can be formally diagnosed through a sleep study. Consult with both your doctor and your dentist to see if an oral appliance might be right for you. Whether you’re an existing patient at South Charlotte Dentistry or need to establish a relationship with a dental care team, call us at 704.759.0908 to see how dental care can be part of your overall health care.